Anger as nurses set to prescribe NSAID
Nurses will be able to
prescribe non-steroidal anti-
inflammatory drugs under Government plans to extend nurse prescribing.
Pulse can reveal a consultation document from the Committee on Safety of Medicines, to be published soon, will propose extending the nurses' formulary to include the NSAID diclofenac.
Prescribing experts have condemned the plans as 'frightening' and the GPC has 'concerns' over patient safety.
The plans are part of a significant proposed extension of independent nurse prescribing (see box).
Rosemary Cook, policy lead for nurse prescribing at the Department of Health, told delegates at a Harrogate Management Centre conference in London last month that the department was also looking again at allowing nurses to prescribe antibiotics.
She said: 'There is considerable pressure to move this on and it's very important we develop this work.'
Former CSM member Professor Hugh McGavock condemned the plans for wider NSAID prescribing. 'When we look at NSAIDs we are looking at the most dangerous drugs in the book,' said Professor McGavock, a former GP and now visiting professor of prescribing science at the University of Ulster.
Between 25 and 35 per cent of all reports of serious adverse events a year were due to NSAIDs and even some GPs were prescribing them inappropriately, he said. 'If that is happening in general practice, in people trained and experienced in prescribing and who have been supervised, is it safe for nurses to prescribe them?'
GPC prescribing sub-committee member Dr Chaand Nagpaul, a GP in Stanmore, Middlesex, said: 'This is an area that can have significant adverse effects. We need to
exercise a lot of caution when extending prescribing.'
Proposed additions to nurse formulary
to nurse formulary
· Diclofenac for soft tissue injuries
· Salbutamol/terbutaline for acute asthma
· Glucagon/glucose injections for hypoglycaemia
· Oestrogen and progesterone substances and Tibolone for menopausal symptoms
· Amitriptyline, gabapentin and imipramine in palliative care
· Schedule 2 and 3 controlled drugs in palliative care